Background: Severe hypertriglyceridemia (triglyceride >1000 mg/dl) occurs at a rate of 0.4% and is associated with a range of medical complications including severe pancreatitis and its complications like acute kidney injury . Hypertriglyceridemia (HTG) is the third most common cause of acute pancreatitis especially in levels above 1000 mg/dl. It has been suggested that insulin [...]

Background: Choosing Wisely recommends against testing for amylase in the diagnosis and management of acute pancreatitis; however, national CMS data shows over $19 million in charges for amylase laboratory testing per year. Our hospital spent over $341,000 on roughly 38,000 amylase orders in the past year. Purpose: We developed a quality improvement project to reduce [...]

Case Presentation: A 10-year-old Hispanic female with 7 years of episodic cervical lymphadenopathy and fever, presented with typical episode, new abdominal pain and emesis. Review of systems was positive for weight loss, night sweats, and diarrhea; she denied rash, cough, sore throat, and arthralgia. History was notable for many prior antibiotics, recently azithromycin and fluconazole [...]

Case Presentation: Patient with prior history of alcohol use presented with abdominal pain, nausea vomiting of 4 days duration. Labs were remarkable for elevated BUN 38 mg/dL, Creatinine 1.9 mg/dL, AST 50 U/L and lipase 771 U/L. CT abdomen and pelvis showed a poorly delineated mass within the head and uncinate process of the pancreas [...]

Case Presentation: A fifty year old female with no significant past medical history presented with one year of acute on chronic bilateral periorbital swelling and twenty pound unintentional weight loss. She also complained of xerostomia and keratoconjunctivitis sicca. Review of systems was positive for intermittent nausea, vomiting, abdominal pain, pruritis, and neck swelling. The patient [...]

Case Presentation: A 29-year-old otherwise healthy male presented to the emergency department with a 1-day history of abdominal pain radiating to his back and associated with nausea and nonbilious vomiting. He denied any fever, chills, heartburn, shortness of breath, chest pain, coughing, urinary symptoms, or change in bowel movements. He denied any previous similar pain. [...]